Partnership and polio

In a new report by the Independent Monitoring Board of the Global Polio Eradication Initiative, which partners with the WHO and other bodies to combat polio around the world, the reasons for Pakistan’s failure in eradicating the disease had been assessed in detail. The report points out that polio made a comeback to the country in menacing fashion in the third quarter of 2018 with a record number of cases reported and then intensified in the second quarter of 2019, with a record 38 cases reported in these three months alone. The IMB has also pointed out that while Khyber Pakhtunkhwa was intended to present a model for polio eradication, there were major outbreaks of polio in that province with most of the 144 cases recorded by the WHO for 2019 reported from that province. The IMB study is currently being examined by the WHO’s executive board.

The factors the IMB has pointed to mentioned the malpractice and poor management we have heard about in the past. But the report also highlights critical factors such as extremely poor team work and differences between public representatives on how to tackle it. The report gives the example of Karachi, a mega city of some 23 million people, which has become a major site for polio cases despite the fact that the population is urbanized and presumably more aware than the rural population. The report says the problem of Karachi is that the ruling PPP has very little cooperation with the city government run by the MQM which manages the overall vaccination effort. This has badly hit the programme. The report also states that generally the government only goes into a neighbourhood to deliver the polio vaccine with the support of a member of parliament. This is also true of other parts of the country. A striking comparison has been made between Nigeria and Pakistan in its efforts against polio. Nigeria, which is now polio-free, has recently completed a national election just like Pakistan. However, the difference is that elected representatives have not allowed political differences to hurt people who need protection from polio. All three chairmen of the Nigerian Health Committees from different political parties have taken part in polio campaigns as have others elected to the lower and upper houses.

The report also points out that there is a lack of coordination between different agencies and that polio has now expanded outside its core reservoirs. For the country where new polio cases continue to be reported this yea,r the situation is a dangerous one. The IMB also stresses the need for Afghanistan and Pakistan to work together given the issue of cross-border transmission. Pakistan has in the past blamed Afghanistan for polio cases in its territory. But a disease should not become a game of political upmanship. Both within the country and in the region health teams must work together if the polio is to be ever successfully wiped out and the gains seen till the end of 2018 built on.